Burlington County Scholastic League Pay Voucher
ATHLETIC TRAINING
B BASKETBALL
FOOTBALL
G BASKETBALL
DATE:
B SOCCER
WRESTLING
G SOCCER
SWIMMING
FIELD HOCKEY
BASEBALL
CROSS COUNTRY
SOFTBALL
TRACK
OPPONENT:
FEE/HOURS:
STATE:
ZIP:
VOLLEYBALL
G LACROSSE
TENNIS
B LACROSSE
NAME:
ADDRESS:
CITY:
Same Address
New Address
SOCIAL SECURITY NUMBER:
SIGNATURE:
SIGN
SIGN
CHECK NUMBER:
DATE MAILED:
ATHLETIC TRAINING
B BASKETBALL
FOOTBALL
G BASKETBALL
DATE:
B SOCCER
WRESTLING
G SOCCER
SWIMMING
FIELD HOCKEY
BASEBALL
CROSS COUNTRY
SOFTBALL
TRACK
OPPONENT:
FEE/HOURS:
STATE:
ZIP:
VOLLEYBALL
G LACROSSE
TENNIS
B LACROSSE
FEE:
NAME:
ADDRESS:
CITY:
Same Address
New Address
SOCIAL SECURITY NUMBER:
SIGNATURE:
SIGN
SIGN
CHECK NUMBER:
DATE MAILED:
ATHLETIC TRAINING
B BASKETBALL
FOOTBALL
G BASKETBALL
DATE:
B SOCCER
WRESTLING
G SOCCER
SWIMMING
FIELD HOCKEY
BASEBALL
CROSS COUNTRY
SOFTBALL
TRACK
OPPONENT:
FEE/HOURS:
STATE:
ZIP:
VOLLEYBALL
G LACROSSE
TENNIS
B LACROSSE
NAME:
ADDRESS:
CITY:
Same Address
New Address
SOCIAL SECURITY NUMBER:
SIGNATURE:
SIGN
SIGN
CHECK NUMBER:
DATE MAILED:
League President Signature:
“I hereby certify that I am not an employee of the Burlington County Scholastic League, that I am an independent contractor, that no funds will be withheld from
monies due me for any purpose, and that I am not dependant on the BCSL for any payments or benefits not specified in this payment voucher. Once completed, please
forward the voucher to the Burlington County Scholastic League Treasurer.”
FEE: